The Center for Disease Control (CDC) has recommended to every state that they should classify ethnic minorities as critical and vulnerable groups in their vaccine distribution plans. Twenty five states have pledged to focus on racial and ethnic communities in prioritizing who received a coronavirus vaccine. Those states now prioritize black, Hispanic and indigenous residents over white residents.
The CDC guidance comes after the Food and Drug Administration (FDA) authorized an emergency rollout of the Moderna COVID-19 vaccine to augment the Pfizer vaccine already being distributed. Yet, the CDC was prioritizing vaccination based on racial diversity. Additionally many are questioning the designation of industries that the CDC deemed "essential."
The CDC website includes "providing justice" in the "ethics" portion of prioritizing the vaccine rollout. In the first stage of the rollout, most states followed the CDC recommendation that health care workers and nursing home residents receive the doses first.
California, Louisiana, New Mexico, North Carolina, and Indiana have listed fairness and equity as key principles in deciding who is prioritized for the vaccine. Rachael Banks, head Oregon's public health department said that vaccines would be "…particularly focused on our communities of color who've seen unfair disproportionate impact from COVID-19."
Maine developed a "Racial/Ethnic Minority COVID-19 Vaccination Plan" while North Carolina "…specifically cited historically marginalized populations as an early-phase critical population group." California Governor Gavin Newsom said that health officials are "…making sure black and brown communities disproportionately are benefited because of the impact they have felt disproportionately because of COVID-19."
Dr. Scott Gottlieb, the former FDA commissioner said recently in an interview on Face the Nation, "If your goal is to maximize the preservation of human life, then you would bias the vaccine toward older Americans. If your goal is to reduce the rate of infection, then you would prioritize essential workers. So it depends what impact you’re trying to achieve."
According to the The New York Times, "The trade-off between the two is muddied by the fact that the definition of 'essential workers' used by the CDC comprises nearly 70 percent of the American work force, sweeping in not just grocery store clerks and emergency responders, but tugboat operators, exterminators and nuclear energy workers."
The Times continued that using "ethics" as the deciding position "…runs counter to frameworks proposed by the World Health Organization, the National Academies of Sciences, Engineering, and Medicine, and many countries, which say that reducing deaths should be the unequivocal priority and that older and sicker people should thus go before the workers, a view shared by many in public health and medicine."
Conceivably, the CDC guidelines could even prioritize a young, healthy, thirty year old member of a minority group over an 85 year old in the same minority group, who is more at risk.
Despite the obvious discrimination and the recommendations of many organizations to prioritize reducing deaths, President Elect Joe Biden's pick to head vaccine distribution, Yale University's Dr. Marcella Nunez-Smith, is being seen as an indication that the Biden administration will use the social justice distribution model.
According to a recent study entitled Characteristics Associated with Racial/Ethnic Disparities in COVID 19 Outcomes in an Academic Health Care System "…racial disparities existed in COVID-19 outcomes that cannot be explained after controlling for age, sex, socioeconomic status, and comorbidity score; therefore, targeted interventions to support high-risk populations are needed."
After the pushback to their social justice prioritized vaccine distribution plan, the CDC revised their recommendations so that Americans over the age of 75 will get their vaccination alongside essential workers.